HomeMy WebLinkAbout98-7602
BUILDING PE,RMIT
7602 A
~2S0
CITY OF ZEPHYRHILLS
(813) 788-6611
;2~-'ClV --
ELECTRICAL PLUMBING MECHANICAL Sewer Conn ;;> cr 1', ,~
{. Water Conn: :1-1 f", ? S-
P,"perty Owne' A_ ~N> i:.-;2t; )iL~ ~"e: Mete,
Job Address: ~ __ ___--= =;__ _. T.I.F. s.
Parcel I. D. #
Permit
Date .y -;"0 .- ?f/
~-:,~
BUILDING
+-
FINAL
C.O.
/ ~
Ij-/-Y;{
Zoning:
NO OCCUPANCY BEFORE C.O.
Complete Plans. Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Inspector
Permit Fee
Signature
Company
Address
Telephone#
J :l;Q~~
Valuation or
Contract Price r tr7rtJ . d"))
,.,)
--
City license Registration # ;;J........3 /-s
State Certified license#
.rII~..j!CYb' YLj_,.tf'-3:J% ~~
BUILDING ELECTRICAL PLUMBING
)lh9
D q
:1, :? ~-
MECHANICAL
Kll
Tp. Servo t
Rough In 3 h1. ~
Meter Can
Const. Pole
Pool
Pre-Meter
Final
6: II
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Ftr.
Pre SLB
lintel
FRM. :J/nki
Insul. CL
WL
Driveway
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($ 1-5.00') shall be made for each trip for each trade:
.;J..-5-.tJiJ
a. Wrong Address
b. Condemned work resulting from faulty construction.
C. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
Wm. A. "Bill" Burgess
Director of Building.
Licensing. & Zoning
City of Zephyrhills
Building Department
5335 Eighth Street
(813) 788-6611
ZephyrhilIs. Florida 33540
INSPECTION REQUEST
PERMIT # : 7 (p 0 Z ES
TYPE OF
INSPECTION: 6Ll)L-D~N~ hJAL
DATE REQUESTED: 4 - ) ~ 98
SIGNATURE:
APPLICATION FOR PERKIT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
OWNER'S NAKE
I~~PE~OEJT 140""E. 1-\e.AL.I'" ~(l.UIGE~
PHONE (e,,31 780. /SfiJu
JOB ADDRESS
38z~~ OAO~HTE2~ ~o~o
"A"" AS A~\IE.
5ulr~ ~ , ZEP~YtZ.HII..&.S . FLil. '31~Lla
OWNER'S ADDRESS
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL I. D. f
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:_New Construction _Addition -L.A1teration _Repair _Install
_Sign _Kove _Deaolish
PROPOSED USE: _Single Faaily _KIF _' of Units _K/H
....L<=<-ercial _Indust. _Swia. Pool _Other
_Restaurant & Health Departaent Approval
ItJrt.
DESCRIPTION OF WORK: ADO T/,.)l) uli\V wAu...47, lOp II "-lAra. G(.,()$f;'r , {JtYMcltY'
BUILDING SIZE:
11& I .&AI
I-V X 7U.
Square Feet.
Height
RESIDENTIAL :
COMMERCIAL :
ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS.
ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERKITS REOUESTED
4. BUILDING
~ELEC'lRICAL
$
5,000. DO
Valuation of Total Construction
AMP Service
Florida Power Corp.
W.R.E.C.
~ClWU.CAL
.1...PLutmING
$
Valuation of Kechanical Installation
GAS
ROOFING
SPECIALTY
,
TYPE OF CONSTRUCTION: ~Block _Fraae _Steel
Other
PIRISBED FLOOR ELEVATIONS:
FT.
IS PROJEC'I' IN FLOOD ZONE AREA 'I ~
YES NO
******************************************
Signature
CONTRAC'I'OR SECTION
COKPARY Ca~l" STMmA2:rl- CDN:snwc..t161J CD. I...."'. /'
State Cert. or Regist. t C-C2L. 0" ~1q
City License Registration t .;L3 /~-
**********************************
BUTI.DER
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*** ************************************
COKPARY 5C.O"6 '5 '"P"utMe""'.la Se/ZU(u
State Cert. or Regist. .
City License Registration .
******************************************
.~v
PLUMBER
r2.3 t:J..J- a::tr
V'
Signature
KECBANICAL COKPARY
State Cert. or Regist. *
Signature City License Registration t
******************************************
OTRRR COKPARY
State Cert. or Regist. #
Signature City License Registration #
******************************************
APPLICATION APPROVED BY PERKIT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Ibe under.lgooi ooder.taods tbat tbl. ....It oar be .obJect to 'deed re.trlction.' whlcb oar be BOre ,estrictl.. than City
regulations. The undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CON'l'RAC'l'On RESPONSIQIL.ITIEB
If the owner has hired a contractor or contractors to undertake work, they lay be required to be licensed in accordance witb
state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor lay be
cited for a .I.d.....or violation ooder .tate I". If Lbo o.ner or Inteodoi contractor are uocertaln as to rlat li....ing
requir8lents lay apply for the intended work, they are advised to contact tbe City of Zephyrbills Building Deparllent, (813)
788-6611. .
FurtherlOre, if the ONner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of tbe
.Contractor Sections" of this application for which tbey will be responsible. If you, as tbe ONDer sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the work. If tbe contractor wisbes you to sign
as contractor that lay be an indication that he is not properly licensed and is not entitled to perlitting priVileges in the
City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND U'!'ILITY CONNECTION FEES
,'-'
,
D. CONSTRUC'l'ION LIEN Lnw (CHAPTER '113, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law _ HOIeOWOer's Protection
Guidft" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If tbe applicant is SOlBOne other than the
"owner", I certify that I have obtained a copy of the above described doculent and prOlise in good faith to deliver it to the
"owner" prior to cOllenCelent.
E. CONTRACTOR' S/OWNER' S AFFIDAVI'!'
I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance witb all
applicable laws regulating construction, loning, and land developlent.
,
Application is hereby lade to obtain a perlit to do work and instailation as indicated. I certify that no wort or
installation has cOllenced prior to issuance of a perlit and tbat all work will be perf OIled to leet standards of all laws
regulating construction, City codes, loning regulations, and land developlent regulations in tbe jurisdiction. I also
certify that I understand that the regulations of other goverDlental agencies lay apply to the intended wort, and tbat it is
IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not liJited to:
· DeparLlent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and BnviroDlBDtally Sensitive Lands,
. Water/Wastewater Treatlent
· Southwest Florida Water Hanag8lent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
· ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
· De arllent of Health & Rehabilitative Services EnviroDlental Health Unit - Wells, Wastewater TreatJent, Septic 'ants
I US EnviroDlental Protection Agency - Asbestos abat8lent
I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood .tbat a drainage plan
addressing a "cOlpensating volUle" will be sublitted which is prepared by a professional engineer registered in tbe State of
Florida prior to perlit. issuance.
. A perlit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor shall is~u~ce of a per.it prevent the Building Official frOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Every per.it issued shall beCOlB invalid
unless tbe work autboriled by such perlit is COllenced within six IOnths of issuance, or if work authorized by the perlit is
suspended or abandoned for a period of six IOnths after the tile the work is cOllenced. One 90 day eltension of tile, JaY be
allowed for the perlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
approved inspection lUst be logged during each six IOntb period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCBHBNT HAY RESULT IN YOUR PAYING 'fIIICE FOR IHPROVBIIDIS TO YOUR
PROPBRTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LBNDBR OR AN ATTORNBY BEFORE RECORDIMG YOUR NOTICI OF
COHHIIOiHIHr. J088 UIlOR 12,500 IN VAtUl bo NOT HIID IV "!CORD AND lUST A 'NOTICE or~'.
SIOOTwm: ~L~ ~
SIGNATURE: OWNBR OR AGBNT
. I
STATB OF FLORIDA
COUNTY OF
The foregOing instrument
before me this
was acknowledged
, 19_ by
STATE OF FLORIDA
COUNTY OF F(.t)t'C'A
The foregoing instrument
before me this 17~
was acknowledged
, 19.1!- by
~ 1f1(.Uf
who is personally known to me or who has
produced
as identification and who did/did not
take an oath.
who is known to me or who bas
produ
as ide ~on and who did/did not
take an Jt;~
(Signature)
11 K C"l1tDSc
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
(Signature)
(Name Typed, Printed or Stamped)
NOTARY PUBLIC
OTHY L GROSZ
..fIl'I .... TIM isslon Cca81218
if My Comm
Expw.. Apr. 04. 1998
* * Bonded by ANB
"-i 1300-852-5878
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.. .... GROSZ & STAMPER CONSTRUCTION COMPAN~ INC.
Date: March 17, 1998
Attn: Building Department
City of Zephyrhills
Fax:
Pages: 02
REFERENCE: Application for Building Permit
Office Interior Work at 38233 Daughtery Road, Suite B
9310 North 16th Street. Suite 101 . Tampa, Florida 33612
PHONE (813) 930-0664 FAX (813) 931-4335
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CITY OF ZEPHYRHILLS CONNECTION FEES TABLE A - WORKSHEET
(INSIDE)
ORD. #395/RESOLUTIONS 312/372 WATER $1.75 GAL. SEWER $6.39/GAL
RESIDENTIAL (Each Lot or Unit)
Residence $ 350.00 $ 1,278.00
Travel Trailer Park $ 131.25 $ 479.25
COMMERCIAL (Per fixture)
Sinks $ 87.50 $ 319.50
Water Closet $ 131.25 $ 479.25
Urinal $ 87.50 $ 319.50
Lavatorv $ 43.75 $ 159.75
Tub/Shower $ 87.50 $ 319.50
Washina Machine-Commercial Size $ 350.00 $ 1,278.00
Washina Machine-Domestic Size $ 87.50 $ 319.50
Dishwasher-Limited Use $ 87.50 $ 319.50
Food Service-Dishwasher $ 700.00 $ 2,556.00
Sinks (3-Com Dartment) $ 175.00 $ 639.00
Car Wash Per stall) $ 1,000.00 $ 6,390.00
Car Wash (Reclaimed water) Per stall' $ 500.00 $ 3,195.00
SINKS 50 I $ 81 -150 $ ~l~ -~() $ ~f)7 -00
WATER CLOSETS 75 , $ ,,,, l -~ $ LI''1 -2.~ $ ~/O -~()
URINALS 50 $ - $ - $ -
LAVATORIES 25 $ - $ - $ -
TUB/SHOWERS 50 $ - $ - $ -
WASH. MACH. COMM. 200 $ - $ - $ -
WASH. MACH DOM. 560 $ - $ - $ -
DISHWASHER COMM. 400 $ - $ - $ -
DISHWASHER LIMITED USE 60 $ - $ - $ -
SINKS-3 COMPARTMENT 100 $ - $ - $ -
CAR WASH PER/STALL 1000 $ - $ - $ -
CAR WASH (RECLAIMED WATER) PER/STALL N/A $ - $ -
SUB-TOTAL $ 118 -"1~ $1~0 -7~ $ I () /7 -50
WATER METER
GRAND TOTAL $ I () 17 -'50
FIXTURE
G.P.D.
#
WATER
SEWER TOTAL PER FIXTURE